| Foothills Neurological Medical Gp | |
|
1330 W Covina Blvd #103 San Dimas CA 91773-3200 | |
| (909) 592-2145 | |
| (909) 599-6217 |
| Full Name | Foothills Neurological Medical Gp |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 1330 W Covina Blvd, San Dimas, California |
| Authorized Official Name and Position | Gail E Young (ADMINISTRATOR) |
| Authorized Official Contact | 9095922145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Neurological Medical Gp 1330 W Covina Blvd #103 San Dimas CA 91773-3200 Ph: (909) 592-2145 | Foothills Neurological Medical Gp 1330 W Covina Blvd #103 San Dimas CA 91773-3200 Ph: (909) 592-2145 |
| NPI Number | 1154317584 |
|---|---|
| Provider Enumeration Date | 09/21/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154317584 | NPI | - | NPPES |
| 00A334060 | Medicaid | CA | |
| 00A435230 | Medicaid | CA |
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